6 known interactions • 3 major • 2 moderate • 1 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Cyclosporine
Cyclosporine dramatically increases rosuvastatin AUC ~7-fold, raising myopathy and rhabdomyolysis risk.
Management: Contraindicated combination. Do not exceed 5 mg rosuvastatin if unavoidable.
Gemfibrozil
Inhibits rosuvastatin metabolism and transport; increases statin exposure ~2-fold and myopathy risk.
Management: Avoid combination. If fibrate therapy is needed, fenofibrate is preferred.
Protease inhibitors (lopinavir/ritonavir, atazanavir/ritonavir)
HIV protease inhibitors substantially increase rosuvastatin exposure, raising myopathy risk.
Management: Limit rosuvastatin to 10 mg/day with lopinavir/ritonavir; 20 mg/day with atazanavir/ritonavir.
Warfarin
Rosuvastatin may increase warfarin anticoagulant effect; mechanism incompletely understood.
Management: Monitor INR frequently when starting, adjusting, or stopping Crestor.
Niacin (≥1 g/day)
High-dose niacin combined with a statin increases myopathy/rhabdomyolysis risk.
Management: Use lowest effective statin dose; advise patient to report unexplained muscle pain.
Antacids (aluminum and magnesium hydroxide combination)
Reduces rosuvastatin Cmax and AUC by ~50%.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Crestor. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.